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Ghali H, Bouhlel H, Bhiri S, Helal S, Zitouni C, Somaii S, Ben Othmen T, Belhadj N, Ben Saad O, Balhi S, Khefacha S, Ben Rejeb M, Ben Cheikh A, Said Latiri H. [Knowledge and practices of the steps prior to the sterilization of heat-resistant medical devices: Study at University Hospital Centre of Sahloul, Sousse-Tunisia - 2022]. Ann Pharm Fr 2024:S0003-4509(24)00060-9. [PMID: 38649136 DOI: 10.1016/j.pharma.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 03/09/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVES The standard process of central sterilization is crucial for the optimal functioning of the operating room. The outcome of this process is closely linked to the steps preceding the steps prior to the sterilization step itself. These steps include pre-disinfection carried out in the operating rooms and other stages, namely washing, drying and packaging, which must be performed in the central sterilization unit. In this context, this study aimed to describe the knowledge of the staff in the operating rooms and the central sterilization unit at Sahloul University Hospital in Sousse (Tunisia) in 2022, regarding the steps prior to the sterilization of reusable thermoresistant medical devices and to describe their practices in terms of compliance with these steps. METHOD A descriptive study was conducted from January 2022 to June 2022 with the aforementioned staff, using a self-administered questionnaire to assess their knowledge of the pre-sterilization steps and a direct observation audit of their practices with regard to these steps. Both measurement instruments were pre-tested. RESULTS Out of 102 self-administered questionnaires (knowledge assessment) distributed to the staff concerned, only 80 were returned and correctly filled out, giving a response rate of 78.4%. Participants' responses regarding the order of steps prior to the sterilization were incorrect in 64% of cases. With regard to the evaluation of professional practices, 224 observations were made in the study area (practice audit). In 82% of these observations, the pre-disinfection step was confused with the washing step. The use of Betadine brushes and scrubbing pads for device washing was noted in 89.3%, along with the absence of swabbing of the canals and hollow parts in 9.4% of cases and the absence of drying of the canals with compressed air. CONCLUSION Mastery of the steps prior to sterilisation of reusable thermoresistant medical devices was insufficient in our institution, suggesting the importance of reinforcing the implementation of the procedure through a continuous training program followed by action plans.
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Affiliation(s)
- Hela Ghali
- Service de prévention et sécurité des soins, CHU Sahloul, Sousse, Tunisie; Faculté de médecine de Sousse, université de Sousse, Sousse, Tunisie
| | - Hela Bouhlel
- Médecine de Famille, faculté de médecine de Sousse, Sousse, Tunisie.
| | - Sana Bhiri
- Service de prévention et sécurité des soins, CHU Sahloul, Sousse, Tunisie; Faculté de médecine de Sousse, université de Sousse, Sousse, Tunisie
| | - Sondes Helal
- École Supérieure des sciences et techniques de la santé de Sousse, Sousse, Tunisie
| | - Chaima Zitouni
- École Supérieure des sciences et techniques de la santé de Sousse, Sousse, Tunisie
| | - Sarra Somaii
- École Supérieure des sciences et techniques de la santé de Sousse, Sousse, Tunisie
| | - Takwa Ben Othmen
- Service de prévention et sécurité des soins, CHU Sahloul, Sousse, Tunisie
| | - Nouha Belhadj
- Médecine de Famille, faculté de médecine de Sousse, Sousse, Tunisie
| | - Omar Ben Saad
- Service de prévention et sécurité des soins, CHU Sahloul, Sousse, Tunisie
| | - Salma Balhi
- Service de prévention et sécurité des soins, CHU Sahloul, Sousse, Tunisie; Faculté de médecine de Sousse, université de Sousse, Sousse, Tunisie
| | - Salwa Khefacha
- Service de prévention et sécurité des soins, CHU Sahloul, Sousse, Tunisie
| | - Mohamed Ben Rejeb
- Service de prévention et sécurité des soins, CHU Sahloul, Sousse, Tunisie; Faculté de médecine de Sousse, université de Sousse, Sousse, Tunisie
| | - Asma Ben Cheikh
- Service de prévention et sécurité des soins, CHU Sahloul, Sousse, Tunisie; Faculté de médecine de Sousse, université de Sousse, Sousse, Tunisie
| | - Houyem Said Latiri
- Service de prévention et sécurité des soins, CHU Sahloul, Sousse, Tunisie; Faculté de médecine de Sousse, université de Sousse, Sousse, Tunisie
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Laviolle B, Degon PF, Gillet-Giraud C, Thiveaud D, Lechat P, Boïko-Alaux V, Fougerou C, Jolly C, Petit A, Rémy-Jouet I, Yven R, Bouret L, Marrauld L, Vaslet MP, Delay V, Gavory AL, Olle F, Langevin J, Forteau L. Comment prendre en compte la dimension éco-responsable des produits de santé tout au long de leur cycle de vie? Therapie 2024; 79:47-60. [PMID: 37993369 DOI: 10.1016/j.therap.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 10/20/2023] [Indexed: 11/24/2023]
Affiliation(s)
- Bruno Laviolle
- CHU de Rennes, université de Rennes, Inserm, UMR_S 1085 (IRSET), CIC Inserm 1414, 35000 Rennes, France.
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Thiveaud D, Orlikowski D, Ollé F, Camus D, Josseran A, Degon PF, Ferracci C, Fraysse JL, Germe AF, Grumblat A, Guido-Morin P, Jarraya B, Joly AS, Lanier C, Pelayo S, Racle G, Teyssie M. Pourquoi et comment améliorer l’information des patients et de leurs aidants au bon usage de leurs dispositifs médicaux tout au long du parcours de soin ? Therapie 2023; 78:39-52. [PMID: 36424211 DOI: 10.1016/j.therap.2022.10.070] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 10/13/2022] [Indexed: 11/05/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Anne-Sophie Joly
- Collectif national des associations d'obèses, 92800 Puteaux, France
| | | | - Sylvia Pelayo
- Inserm - FCRIN, université de Lille, 59045 Lille, France
| | | | - Myriam Teyssie
- Union Stomisés Grand Sud, 84470 Chateauneuf-de-Gadagne, France
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Lardon A, Leveque M, Martinez T, Bretagnolle C, Henry A. [Supply of sterile medical devices to an interventional technical platform via mobile RFID technology]. Ann Pharm Fr 2022; 81:568-578. [PMID: 36513150 DOI: 10.1016/j.pharma.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 12/01/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
This work presents the eight-month assessment of the mobile RFID (radio frequency identification) technology implementation for the management of sterile medical devices in an interventional cardiology department. Several indicators dedicated to stock management, organizational impact (within the pharmacy and the department) and economic impact were collected. The scope of MDS tracked by RFID was defined as well as the new supply circuit. In total, 297 (83%) references were managed by RFID. At eight months, the number of MDS units in stock has decreased by 35% and the number of overstocked references by more than 50%. The value of the inventory decreased by €30,196 (17%) in three months from an initial amount of €17,995. This decrease has been maintained at eight months. The average time spent by the pharmacy technician (PPH) was 66min/d. The paramedical team gained 180min/week. By integrating the cost of the equipment, the annual subscription and the PPH cost, the benefit is estimated at €9555 the first year (then €17,155 the following years). To conclude, RFID has allowed a significant reduction of the stock and its control over time while securing the supply circuit adjusted to the activity. The limits are the absence of interface between the dedicated software and the ordering software as well as the consequent time dedicated by the PPH to this new management mode.
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Affiliation(s)
- A Lardon
- Service pharmaceutique, hôpital de la Croix-Rousse, groupement hospitalier nord, Hospices Civils de Lyon, 103, Grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France.
| | - M Leveque
- Service pharmaceutique, hôpital de la Croix-Rousse, groupement hospitalier nord, Hospices Civils de Lyon, 103, Grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France
| | - T Martinez
- Service de cardiologie interventionnelle, hôpital de la Croix-Rousse, groupement hospitalier nord, Hospices Civils de Lyon, 103, Grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France
| | - C Bretagnolle
- Service pharmaceutique, hôpital de la Croix-Rousse, groupement hospitalier nord, Hospices Civils de Lyon, 103, Grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France
| | - A Henry
- Service pharmaceutique, hôpital de la Croix-Rousse, groupement hospitalier nord, Hospices Civils de Lyon, 103, Grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France
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Sayin H, Gaillard C, Henry A, Cabelguenne D, Armoiry X. [Impact of the new European regulation 2017/745 on medical devices on hospital pharmacies activity: example on pharmaceutical supply function within a French university hospital center]. Ann Pharm Fr 2021; 80:730-737. [PMID: 34968476 DOI: 10.1016/j.pharma.2021.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 12/21/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The new European regulation (MDR) on medical devices (MD) is expected to have major impacts on the industrial sector, but also consequences on healthcare professionals. Our objective was to evaluate the impact of the MDR on the supply of MDs in hospital pharmacies at the level of a French university hospital. MATERIAL AND METHODS We conducted a prospective follow-up of marketing cessations and supply disruptions directly related to the MDR between November 2019 and September 2020. The data were analyzed accounting for the nature of the suppliers (status/size), the nature of the MDs (route/class), and the proposed alternatives. The economic impact on hospital pharmacies was also estimated. RESULTS Over this period, 96 MD product designations were declared out of stock or in cessation (total of 402 references), of which half corresponded to class IIa MDs, mainly used for surgical procedures. Of the 14 companies concerned (36% French), the majority were manufacturers, of small/medium-size or intermediate size. Substitutions were proposed for only 15 products (15.6%). The cost of pharmaceutical management of these disruptions/ marketing cessations was estimated at 3052euro. CONCLUSION Even before the official date of its application, the impacts of the MDR on the supply function of hospital pharmacies are already visible. In the short, medium and long term, prospective monitoring of the impacts, positive or negative, would seem to be justified at the level of manufacturers, healthcare professionals and end users of MDs.
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Affiliation(s)
- Halil Sayin
- Faculté de Pharmacie, ISPB Université Claude Bernard Lyon 1, 69008 Lyon, France
| | - Claire Gaillard
- Faculté de Pharmacie, ISPB Université Claude Bernard Lyon 1, 69008 Lyon, France; Univ Lyon, UCBL, INSA Lyon, CNRS, MATEIS, UMR5510, 69100 Villeurbanne, France
| | - Agnès Henry
- Service Pharmaceutique, Groupement Hospitalier Nord, Hospices Civils de Lyon, 69004 Lyon, France
| | - Delphine Cabelguenne
- Service Pharmaceutique, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 PIERRE BENITE cedex, France
| | - Xavier Armoiry
- Faculté de Pharmacie, ISPB Université Claude Bernard Lyon 1, 69008 Lyon, France; Univ Lyon, UCBL, INSA Lyon, CNRS, MATEIS, UMR5510, 69100 Villeurbanne, France; Service de pharmacie, hôpital Edouard-Herriot, Hospices civils de Lyon, 69003 Lyon, France.
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Bechar H, Attjioui H, Mimouni H, Ismaili R, Tebaa A, Belahcen J, Rahali Y. Materiovigilance in health centers: The role of notifiers to ensure safer use of medical devices. Ann Pharm Fr 2021; 80:301-311. [PMID: 34571010 DOI: 10.1016/j.pharma.2021.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 07/12/2021] [Accepted: 09/20/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The implementation of efficient health and vigilance strategy is one of the essential aspects of the health policy of public and private health establishments, in order to reduce the risk of incidents due to medical devices. AIM The objective of this study is to demonstrate the importance of user notification and to recognize the role of nursing staff in the materiovigilance process. METHODS This is a retrospective study of materiovigilance cases notified for three years (2016, 2017, and 2018) at the National Institute of Oncology. The evaluation of the incidents was carried out with the aim of taking the necessary measures to prevent and minimize risk. RESULTS Seven thousand three hundred and eight cases of materiovigilance during the 3 years were collected. A spontaneous collection of reports was predominant (70%). The distribution of the number of incidents by the profile of notifiers shows that reports come from surgeons and much more from nurses. The surgical block (35.7%) and medical oncology services (14.3%) were the services that reported more; the majority of the observed adverse events were attributed to infusion sets (n=7105). Four serious cases of materiovigilance. reported during these 3 years at the level of the vigilance unit considered the most relevant were detailed with examples of immediate actions taken and risk minimization actions. CONCLUSION This study highlights the characteristics of incidents reported. The role of the nursing staff and the strong presence of nurses in the vigilance system has been well demonstrated, thus reducing the risk of side effects due to medical devices.
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Affiliation(s)
- H Bechar
- National Institute of Oncology, Ibn Sina University Hospital Center, 10170 Rabat, Morocco
| | - H Attjioui
- Mohammed V University in Rabat- Faculty of Medicine and Pharmacy of Rabat, 10170 Rabat, Morocco.
| | - H Mimouni
- National Institute of Oncology, Ibn Sina University Hospital Center, 10170 Rabat, Morocco; Hassan First University of Settat , Morocco
| | - R Ismaili
- National Institute of Oncology, Ibn Sina University Hospital Center, 10170 Rabat, Morocco; Hassan First University of Settat , Morocco
| | - A Tebaa
- Ministry of Health, Poison Control Center of Morocco, 10170 Rabat, Morocco
| | - J Belahcen
- National Institute of Oncology, Ibn Sina University Hospital Center, 10170 Rabat, Morocco
| | - Y Rahali
- National Institute of Oncology, Ibn Sina University Hospital Center, 10170 Rabat, Morocco; Team of Formulation and Quality Control of Health Products, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, National Institute of Oncology, Ibn Sina University Hospital Center, 10170 Rabat, Morocco
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Hmida MB, Ayed HB, Jmaa MB, Feki H, Damak J. Impact of a training intervention on knowledge and practices of health-care workers about reprocessing reusable medical devices in a South-Tunisian University Hospital. Ann Pharm Fr 2021; 80:460-466. [PMID: 34481786 DOI: 10.1016/j.pharma.2021.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 07/11/2021] [Accepted: 08/27/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Reprocessing of reusable medical devices (RMD) play an important role in the prevention of health-care associated infections. In this perspective, this study aimed to evaluate the impact of a training program intervention on health-care workers' (HCWs) knowledge and hospital practices about the reprocessing of RMD as a main strategic axis of infection control. METHOD We led a pre-post quasi-experimental study to evaluate knowledge of HCWs and to assess hospital practices in reprocessing RMD before and after a training intervention from May to November 2020 in Hedi Chaker University Hospital. A self-administrated questionnaire was distributed for each participant to assess knowledge. To evaluate practical skills, an audit grid was used. RESULTS Overall, 30 participants were included. All HCWs had a fair level of knowledge before training. The knowledge score(KS) has significantly risen from pre to post-training (64/100 vs 80/100; p<0.001). When stratified by RMD type, a significant increase was noted on post intervention in KS about thermo-sensitive RMD reprocessing(p=0.044) and sterilization of thermo-resistant RMD (p=0.004). As for practice assessment, 5(62.5%) departments had a fair level of practice. The conformity score(CS) did not significantly change from baseline to post-follow-up(53.5 vs 56.2; p=0.06). According to the audit sections, we did not find a significant change in the pre- and post-intervention CS in sterilization process(70 vs 80; p=0.06) and in the cleaning and decontamination steps(66.7 vs 67 ; p=0.18). CONCLUSION As opposed to practical skills, positive impact of the training intervention on HCWs knowledge was noted, which underlined the gap between theory and practice.
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Affiliation(s)
- Mariem Ben Hmida
- Preventive Medicine and Hospital Hygiene Department, Hedi Chaker University Hospital, Sfax, Tunisia.
| | - Houda Ben Ayed
- Preventive Medicine and Hospital Hygiene Department, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Maissa Ben Jmaa
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Habib Feki
- Preventive Medicine and Hospital Hygiene Department, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Jamel Damak
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, Sfax, Tunisia
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Reallon E, Laujin H, Cadiergue V, Sainfort-Gallier A. [Breathing filters in hospital, COVID first-wave experience]. Ann Pharm Fr 2021; 80:145-150. [PMID: 33933442 PMCID: PMC8084601 DOI: 10.1016/j.pharma.2021.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 04/27/2021] [Indexed: 11/16/2022]
Abstract
During the coronavirus pandemic, breathing filters have been essential in the medical care of infected patients. The worldwide demand caused a disruption in the supply, which led to a multiplication of the references used. The lack of formation available on the subject was an impediment for pharmacists (buyer, medical devices, intensive car unit) and it appears to be necessary to redact a formation about those filters, from the experience acquired during the sanitary crisis. Multiple breathing filters references exist which may be classify according to their filtration mechanism (mechanical filtration or electrostatic filtration) and by the eventual presence of a humidifying action (Heat and Moisture Exchangers; hydrophobic, hygroscopic, or mixed). In anaesthesia, the use of pure mechanical filter is preferred; in resuscitation unit, heat and moisture exchangers filter or simple filter plus heated humidifier are used. During the COVID-19 pandemic, the filters duration of use has been lengthened to limit the disruption risk.
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Affiliation(s)
- Elsa Reallon
- Université Claude Bernard Lyon 1, France; Service Pharmacie, Centre Hospitalier Ardèche Nord, 07100 Annonay, France.
| | - Hugo Laujin
- Service Réanimation, Centre Hospitalier Ardèche Nord, 07100 Annonay, France
| | - Vincent Cadiergue
- Service Réanimation, Centre Hospitalier Ardèche Nord, 07100 Annonay, France
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Nativel F, Barge F, Prevost N, Solnon A, Gourraud JB, Probst V, Clouet J, Lande G, Grimandi G. From electrophysiological exploration to management of heart arrhythmias: Economic analysis of practices in a high-volume French hospital over two different time periods. Ann Pharm Fr 2021; 79:255-65. [PMID: 33152321 DOI: 10.1016/j.pharma.2020.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 10/09/2020] [Accepted: 10/13/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Medical devices (MD) used to treat arrhythmias range from electrophysiological exploration catheters to intracardiac ablation catheters, and they are continuously undergoing optimization. The inclusion of innovative MD in Diagnosis Related Groups (DRG) of the French healthcare economic system can lead to financial imbalance for health institutions. The objective of this study was to compare cost-revenue analyses for interventional heart rhythm management in a high-volume French hospital between two time periods. METHODS For 3 months in 2014 and 3 months in 2017, all of the patients admitted to the interventional rhythmic unit with arrhythmia were included retrospectively in this monocenter study. All arrhythmias were considered. The primary clinical endpoint was the difference between the expenses and incomes, calculated for each patient. The secondary endpoint was the breakdown of costs. RESULTS 217 patients were included. In 2014 period, the analysis revealed a deficit of 409±1717 euros per patient and an overall deficit for the hospital of 44,635 euros. In 2017 period, the same evaluation indicated a deficit of 446±1316 euros per patient and an overall deficit for the hospital of 48,210 euros. The cost of MD accounts for a significant share of total expenses. CONCLUSION The profitability for the cardiac rhythm activity at our facility was optimized between 2014 and 2017. The reliance on ambulatory care increased. However, the reduction in the expenses incurred did not increase the profitability for the facility. It was offset by a decrease in DRG tariffs. A flowchart-type structure based on these practices analyses for rhythmic disorder treatments was developed.
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Castanié M, Juillard-Condat B, Galian C, Giroud JP, Bagheri H. [Analysis of regulatory status changes of drugs in France: 2010-2019]. Therapie 2020; 76:37-47. [PMID: 32828560 DOI: 10.1016/j.therap.2020.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/06/2020] [Accepted: 06/11/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The existence of borderline products between the status of a medicinal product and other less regulated products allows some products to have different statuses or even to change from one status to another. In order to quantify these changes, a review of medicines that have changed from drug status to other statuses (medical device, cosmetic product or food supplement) in France between 2010 and 2019 was performed. METHOD The lists of medicinal products with archived or revoked marketing authorization (MA) from the French National Authority's Register of Medicinal Products were analyzed in order to identify the medicinal products withdrawn from the market between January 1, 2010 and September 30, 2019 that could be considered as products with a "potential for status change". Then, we searched on the official websites of the MA holders and other firms, for a possible return to the market with a different status, marketed by the same firm (self-change of status) or a different firm (hetero-change of status). RESULTS Out of a list of 206 drugs identified as "with potential for status change", we detected a total of 101 status changes, including 36 auto-changes and 65 hetero-changes. These changes mainly concern vitamin or herbal drugs later marketed as food supplements (30 cases of auto-changes and 60 cases of hetero-changes). There are also 6 cases of switching to cosmetic product and 5 cases of switching to medical device. CONCLUSION The existence of no clear distinction between the different statuses of health products facilitates their status changes. The increasing shift from "medicines" to less regulated products, the trivialization of their use by the public and their increasing consumption make them a fundamental issue of social pharmacology, requiring to raise the awareness of consumers and health professionals.
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Affiliation(s)
- Marie Castanié
- INSERM U1027, service de pharmacologie clinique et médicale, centre de pharmacovigilance et de pharmacoépidémiologie, faculté de médecine, centre hospitalo-universitaire de Toulouse, allées Jules-Guesde, 31000 Toulouse, France
| | - Blandine Juillard-Condat
- Faculté de pharmacie, université Toulouse III, centre hospitalo-universitaire de Toulouse, 31000 Toulouse, France
| | - Christian Galian
- Association de défense, d'éducation et d'information du consommateur, 31100 Toulouse, France
| | | | - Haleh Bagheri
- INSERM U1027, service de pharmacologie clinique et médicale, centre de pharmacovigilance et de pharmacoépidémiologie, faculté de médecine, centre hospitalo-universitaire de Toulouse, allées Jules-Guesde, 31000 Toulouse, France.
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Nativel F, Detraz L, Mauduit N, Riche VP, Desal H, Grimandi G. Economic challenges of using innovative medical devices in major public health pathologies: Example of acute ischemic stroke management by mechanical thrombectomy. Rev Epidemiol Sante Publique 2019; 67:361-8. [PMID: 31662284 DOI: 10.1016/j.respe.2019.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 06/20/2019] [Accepted: 08/28/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Activity-based Funding can induce financial imbalances for health institutions if innovative medical devices (MD) used to perform acts are included in Diagnosis Related Groups (DRG) tariff. To be reimbursed in addition to the DRG tariff, innovative MD must have received a favorable evaluation by the French National Authority for Health (Haute Autorité de Santé) and be registered on the positive list. The aim of this study was to evaluate the expenses and incomes generated by each scenario (before and after the reimbursement of MD), and the financial reports. This study concerned the management of ischemic stroke by mechanical thrombectomy devices, in high-volume French hospital. METHODS All patients who have had an acute ischemic stroke and admitted to the interventional neuroradiology unit between January 2016 and December 2017 were included retrospectively in this monocentric study. They were divided into four subgroups based on the severity of the DRG. The cost study was carried out using the French National Cost Study Methodology adjusted for the duration of the stays and by micro-costing on MD. RESULTS A total of 267 patients were included. Over the study period, the average cost of the hospital stay was €10,492±6364 for a refund of €9838±6749 per patient. The acts performed became profitable once the MD were registered on the positive list (€-1017±3551 vs. €560±2671; P<0.05). Despite this reimbursement, this activity remained in deficit for DRG lowest severity (level 1) patients (€-492±1244). Specific MD used for mechanical thrombectomy represented 37% of the total cost of stay. CONCLUSION The time required to evaluate MD reimbursement files is too long compared to their development. As a result, practitioners are in difficulty to be able to carry out acts according to the consensual practices of their learned societies, without causing any financial deficit of their institutions.
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Maurin A, Petit A, Tilleul P, Combeau D. [ISO 9001 certification of a sterilization unit: Transition to the 2015 version]. Ann Pharm Fr 2019; 77:363-373. [PMID: 31257018 DOI: 10.1016/j.pharma.2019.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/20/2019] [Accepted: 05/06/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The sterilization unit of Pitié-Salpêtrière-Charles Foix hospital group is ISO 9001 certified on one of its sites. The purpose of this work is to describe how the unit prepared for the transition from the 2008 version to the 2015 version of the standard, as well as the conduct of the audit. METHODS The pharmaceutical team has received prior training from French national organization for standardization (Afnor) to understand the new requirements and how to apply them to the sterilization unit. SWOT and PESTEL methods were used. A 3-month retro planning has been established. Deadlines were the annual management review and the certification audit. Audits carried out by the Quality and Risk Management Department helped to identify the priorities. RESULTS The compliance of the quality management system (QMS) has led to the identification of internal and external challenges, relevant stakeholders and risks and opportunities. Management leadership and communication has been strengthened and control over external providers has improved. The auditor did not identify any non-compliance, but said that the system had to mature regarding the recent application of the new requirements. CONCLUSIONS The QMS is more effective, new strengths and weaknesses have been identified and requirements of the unit and stakeholders have been better defined. The pharmaceutical investment necessary for this approach has been important. Involvement in the quality approach of all the staff of the unit lies to the success of the project.
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Affiliation(s)
- A Maurin
- Pharmacie à usage intérieur, Unité fonctionnelle de stérilisation, Groupe hospitalo-universitaire La Pitié-Salpêtrière-Charles-Foix, 47-83, boulevard de l'hôpital, 75013 Paris, France.
| | - A Petit
- Direction Qualité, Gestion des risques, Relations avec les usagers, Groupe hospitalo-universitaire La Pitié-Salpêtrière-Charles-Foix, 47-83, boulevard de l'hôpital, 75013 Paris, France
| | - P Tilleul
- Pharmacie à usage intérieur, Unité fonctionnelle de stérilisation, Groupe hospitalo-universitaire La Pitié-Salpêtrière-Charles-Foix, 47-83, boulevard de l'hôpital, 75013 Paris, France; Pharmacie clinique, Université Paris Descartes, 4, avenue de l'Observatoire, 75006 Paris, France
| | - D Combeau
- Pharmacie à usage intérieur, Unité fonctionnelle de stérilisation, Groupe hospitalo-universitaire La Pitié-Salpêtrière-Charles-Foix, 47-83, boulevard de l'hôpital, 75013 Paris, France
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13
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Painchart L, Drancourt P, Aubert J, Inghels Y, Boyer J. [Interest and difficulties in setting up pharmaceutical reconciliations for patients with dressings for complex wounds]. Ann Pharm Fr 2019; 77:516-531. [PMID: 31255240 DOI: 10.1016/j.pharma.2019.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 03/23/2019] [Accepted: 06/03/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The management of wounds is a commonplace activity in a patient's healthcare pathway. The involvement of the pharmacist in the management of complex dressings can help strengthen the continuity of this care thanks to the pharmaceutical reconciliation. The objective of this study was to improve the quality of information transmitted between the city and the hospital regarding complex wound dressings. METHODS This is a prospective study consisting of two groups in three services (medicine, diabetology, vascular surgery): the control group corresponded to a classic patient care and in the intervention group, the pharmacists performed dressing reconciliations. A follow-up of the patients after coming back home was realized with healthcare professionals of city involved. RESULTS Twenty patients were included in the control group and 19 in the intervention group. Entry conciliation has improved the quality and quantity of information on wounds transmitted between the city and the hospital. Exit conciliation has increased from 60 to 100% wound and dressing output prescriptions. One hundred percent of nurses surveyed were satisfied with the patients care. CONCLUSIONS Reconciliation would improve information transmitted between the city and the hospital and avoid a break in the continuity of complex wounds cares. However, the time dedicated and the adhesion of the care services were difficulties encountered. This study is the first highlighting the interest of medical device reconciliation and could allow reconciliation extension toward other medical devices.
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Affiliation(s)
- L Painchart
- Service dispositifs médicaux, pôle pharmacie, centre hospitalier de Valenciennes, 59000 Valenciennes, France.
| | - P Drancourt
- Service dispositifs médicaux, pôle pharmacie, centre hospitalier de Valenciennes, 59000 Valenciennes, France
| | - J Aubert
- Service dispositifs médicaux, pôle pharmacie, centre hospitalier de Valenciennes, 59000 Valenciennes, France
| | - Y Inghels
- Service dispositifs médicaux, pôle pharmacie, centre hospitalier de Valenciennes, 59000 Valenciennes, France
| | - J Boyer
- Service dispositifs médicaux, pôle pharmacie, centre hospitalier de Valenciennes, 59000 Valenciennes, France
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14
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Vaillant T, Motte AF, Haghighat S, Colon P, Paubel P, Duhamel C. [Evaluation of dental medical devices: Focus on the definition of needs]. Ann Pharm Fr 2019; 77:232-240. [PMID: 30961889 DOI: 10.1016/j.pharma.2019.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 01/21/2019] [Accepted: 01/30/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVES As a university teaching hospital, the call for tender for dental medical devices (dental implants and consumables) is done with the help of a team of hospital pharmacists and users. In order to optimize the definition of needs and evaluation criteria, an exhaustive review of the products was carried out. METHODS Dental medical devices suppliers were consulted in 2017 for reviewing their products. Their technical, clinical and economic data were compared. The products have been gathered into categories and its results had been submitted to a commission of dental experts of our university hospital for clinical opinion. RESULTS More than 30,000 references from 30 different suppliers were analyzed (orthodontics, dental implants, membranes and bone substitutes, various dental consumables). Relating to oral implantology, the opinions converged on clinical studies. On the contrary, diverging opinions have been proffered on the systematic use of single-use drills and customized guides for surgery and on the implant's choice. The definition of needs has been specified for orthodontics and consumables. Other criteria played a great role: single packaging (unit doses), product's sterility, paediatric needs, presence of allergens, traceability of devices and supplier diversity. CONCLUSIONS This review led to the identification of new needs in more precise terms. The complexity and diversity of dental products and techniques requires this careful review and a better collaboration with practitioners.
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Affiliation(s)
- T Vaillant
- Unité évaluation et achats des dispositifs médicaux, service évaluations pharmaceutiques et bon usage, Agence générale des équipements et produits de santé (AGEPS), Assistance Publique-Hôpitaux (AP-HP) de Paris, 7, rue du Fer à Moulin, 75005 Paris, France
| | - A-F Motte
- Unité évaluation et achats des dispositifs médicaux, service évaluations pharmaceutiques et bon usage, Agence générale des équipements et produits de santé (AGEPS), Assistance Publique-Hôpitaux (AP-HP) de Paris, 7, rue du Fer à Moulin, 75005 Paris, France
| | - S Haghighat
- Unité évaluation et achats des dispositifs médicaux, service évaluations pharmaceutiques et bon usage, Agence générale des équipements et produits de santé (AGEPS), Assistance Publique-Hôpitaux (AP-HP) de Paris, 7, rue du Fer à Moulin, 75005 Paris, France
| | - P Colon
- Service d'odontologie, université Paris-Diderot, hôpital Rothschild, Assistance Publique-Hôpitaux (AP-HP) de Paris, 75012 Paris, France
| | - P Paubel
- Unité évaluation et achats des dispositifs médicaux, service évaluations pharmaceutiques et bon usage, Agence générale des équipements et produits de santé (AGEPS), Assistance Publique-Hôpitaux (AP-HP) de Paris, 7, rue du Fer à Moulin, 75005 Paris, France; Unité évaluation scientifique, bon usage et information, service évaluations pharmaceutiques et bon usage, Agence générale des équipements et produits de santé (AGEPS), Assistance Publique-Hôpitaux (AP-HP) de Paris, 75005 Paris, France; Inserm UMR S 1145, faculté de pharmacie, université Paris Descartes - Sorbonne Paris cité, institut droit et santé, 75006 Paris, France
| | - C Duhamel
- Unité évaluation et achats des dispositifs médicaux, service évaluations pharmaceutiques et bon usage, Agence générale des équipements et produits de santé (AGEPS), Assistance Publique-Hôpitaux (AP-HP) de Paris, 7, rue du Fer à Moulin, 75005 Paris, France.
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Camus D, Thiveaud D, Josseran A. Nouveau règlement européen des dispositifs médicaux : comment l’écosystème français doit saisir l’opportunité d’EUDAMED et du système IUD, tout en dépassant les contraintes. Therapie 2019; 74:59-72. [PMID: 30553534 DOI: 10.1016/j.therap.2018.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 11/05/2018] [Indexed: 10/27/2022]
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16
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Clou E, Dompnier M, Kably B, Leplay C, Poupon E, Archer V, Paul M. [Impact of an automated dispensing system for medical devices in cardiac surgery department]. Ann Pharm Fr 2017; 76:64-70. [PMID: 29174609 DOI: 10.1016/j.pharma.2017.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 10/09/2017] [Accepted: 10/13/2017] [Indexed: 10/18/2022]
Abstract
To secure medical devices' management, the implementation of automated dispensing system in surgical service has been realized. The objective of this study was to evaluate security, organizational and economic impact of installing automated dispensing system for medical devices (ASDM). The implementation took place in a cardiac surgery department. Security impact was assessed by comparing traceability rate of implantable medical devices one year before and one year after installation. Questionnaire on nurses' perception and satisfaction completed this survey. Resupplying costs, stocks' evolution and investments for the implementation of ASDM were the subject of cost-benefit study. After one year, traceability rate is excellent (100%). Nursing staffs were satisfied with 87.5% by this new system. The introduction of ASDM allowed a qualitative and quantitative decrease in stocks, with a reduction of 30% for purchased medical devices and 15% for implantable medical devices in deposit-consignment. Cost-benefit analysis shows a rapid return on investment. Real stock decrease (purchased medical devices) is equivalent to 46.6% of investment. Implementation of ASDM allows to secure storage and dispensing of medical devices. This system has also an important economic impact and appreciated by users.
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Affiliation(s)
- E Clou
- Hôpital Henri-Mondor, 94000 Créteil, France.
| | - M Dompnier
- Hôpital Henri-Mondor, 94000 Créteil, France
| | - B Kably
- Hôpital Henri-Mondor, 94000 Créteil, France
| | - C Leplay
- Hôpital Henri-Mondor, 94000 Créteil, France
| | - E Poupon
- Hôpital Henri-Mondor, 94000 Créteil, France
| | - V Archer
- Hôpital Henri-Mondor, 94000 Créteil, France
| | - M Paul
- Hôpital Henri-Mondor, 94000 Créteil, France
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17
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Ferrand É, Painchart L, Grimandi G, Décaudin B, Bussières JF. [The roles and the impacts of pharmacists in the management of medical devices at the hospital: A literature review]. Ann Pharm Fr 2017; 75:409-419. [PMID: 28666516 DOI: 10.1016/j.pharma.2017.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 05/09/2017] [Accepted: 05/22/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Identify the training profile and the published evidences about the roles and the impacts of hospital pharmacists in medical devices. METHODS A literature review was conducted using Google, Google Scholar and Pubmed for 1990-2016 associated with a manual search conducted in three non-indexed pharmaceutical journals for 2000-2016. RESULTS The analysis of training programs available did not allow us to identify a specific training profile. A total of 72 articles related to the roles and the impacts of the pharmacist were identified, 52 of which came from non-indexed journals. Those articles did not deal specifically about the roles and the impacts of pharmacist; however, articles were analyses for three spheres including the referencing of medical devices (n=36), the evaluation (n=19) and the distribution system (n=13). CONCLUSIONS French pharmacists have many theoretical and practical training opportunities. There are a few articles describing precisely the roles and the impacts of hospital pharmacists in medical device. It appears urgent to better document this activity in professional and indexed literature.
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Affiliation(s)
- É Ferrand
- Unité de recherche en pratique pharmaceutique, département de pharmacie, CHU Sainte-Justine, 3175, chemin de la Côte-Sainte-Catherine, Montréal, QC, Canada, H3T 1C5
| | - L Painchart
- Unité de recherche en pratique pharmaceutique, département de pharmacie, CHU Sainte-Justine, 3175, chemin de la Côte-Sainte-Catherine, Montréal, QC, Canada, H3T 1C5
| | - G Grimandi
- Pharmacie centrale, hôpital St-Jacques, CHU de Nantes, 85, rue St-Jacques, 44093 Nantes, France
| | - B Décaudin
- EA 7365, groupe de recherche sur les formes injectables et les technologies associées [GRITA], université de Lille, CHU de Lille, 59000 Lille, France
| | - J-F Bussières
- Unité de recherche en pratique pharmaceutique, département de pharmacie, CHU Sainte-Justine, 3175, chemin de la Côte-Sainte-Catherine, Montréal, QC, Canada, H3T 1C5; Faculté de pharmacie, université de Montréal, Montréal, QC, Canada.
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18
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Perroy AC. [m-health in an age of e-health. Promises, challenges and liabilities]. Ann Pharm Fr 2016; 74:421-430. [PMID: 27139163 DOI: 10.1016/j.pharma.2016.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 03/01/2016] [Accepted: 03/10/2016] [Indexed: 11/29/2022]
Abstract
e-Health offers perspectives for patients, healthcare professionals and healthcare system, although this concept appears difficult to appreciate and to define. Uncertainties remain on the efficiency of these tools and their safety in particular with respect to personal data of the patients. Thus, we can observe the emergence of new categories of liabilities, not only with respect to the development of these new tools, but also regarding their distribution.
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Affiliation(s)
- A-C Perroy
- Universités en droit pharmaceutique, Lille 2, Cabinet Simmons & Simmons, Lille, France.
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19
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Ganry L, Blot P, Balandier S, Bouric JM, Sabouni W, Corre P, Khonsari RH. [Quantitative study of phonation by aerophonoscopy: Reproducibility study on healthy volunteers]. ACTA ACUST UNITED AC 2016; 117:62-6. [PMID: 26704194 DOI: 10.1016/j.revsto.2015.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Revised: 09/29/2015] [Accepted: 11/04/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The aerophonoscope allows for recording buccal and nasal airflow during breathing and speech and the sounds emitted by the patient. It is known to be useful in the postoperative follow-up of cleft lip and palate children, but there are currently no studies that quantitatively validate its reliability in pathological or non-pathological situations. The aim of our study was to measure the reliability of aerophonoscopic measures in adult healthy volunteers. MATERIAL AND METHODS A quantitative evaluation of the reliability of aerophonoscopy has been carried out in 30 healthy adult volunteers by measuring its inter- and intra-individual reproducibility and its sensibility in relation with the degree of the velopharyngeal sphincter constriction using a test-retest protocol. RESULTS The aerophonoscope allows for inter- and intra-individual reproducible measures in healthy adult volunteers. Its sensibility to velopharyngeal sphincter constriction is good in healthy adult volunteers. DISCUSSION The interest of aerophonoscopy in the treatment strategy of cleft lip and palate patients remains unclear. More reliable quantitative data would be of major interest to determine whether this device is suitable for the follow-up of cleft lips and palate patients or not. This would also allow for planning a second soft-palate operation and for assessing the efficacy of revision surgery such as superior or inferior pedicled pharyngoplasty.
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Montmartin M, Meyer C, Euvrard E, Pazart L, Weber E, Benassarou M. [3D printing in health care facilities: What legislation in France?]. ACTA ACUST UNITED AC 2015; 116:302-7. [PMID: 26071022 DOI: 10.1016/j.revsto.2015.04.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 04/30/2015] [Indexed: 11/16/2022]
Abstract
Health care facilities more and more use 3D printing, including making their own medical devices (MDs). However, production and marketing of MDs are regulated. The goal of our work was to clarify what is the current French regulation that should be applied concerning the production of custom-made MDs produced by 3D printing in a health care facility. MDs consist of all devices used for diagnosis, prevention, or treatment of diseases in patients. Prototypes and anatomic models are not considered as MDs and no specific laws apply to them. Cutting guides, splints, osteosynthesis plates or prosthesis are MDs. In order to become a MD manufacturer in France, a health care facility has to follow the requirements of the 93/42/CEE directive. In addition, custom-made 3D-printed MDs must follow the annex VIII of the directive. This needs the writing of a declaration of conformity and the respect of the essential requirements (proving that a MD is secure and conform to what is expected), the procedure has to be qualified, a risk analysis and a control of the biocompatibility of the material have to be fulfilled. The documents proving that these rules have been respected have to be available. Becoming a regulatory manufacturer of MD in France is possible for a health care facility but the specifications have to be respected.
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Affiliation(s)
- M Montmartin
- Génie biomédical, institut supérieur d'ingénieurs de Franche-Comté (ISIFC), université de Franche-Comté, 25030 Besançon cedex, France
| | - C Meyer
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; EA 4268, laboratoire intervention, innovation, ingénierie en santé (Li4S), université de Franche-Comté, 25030 Besançon cedex, France.
| | - E Euvrard
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; EA 4268, laboratoire intervention, innovation, ingénierie en santé (Li4S), université de Franche-Comté, 25030 Besançon cedex, France; Centre d'investigation clinique en innovation technologique (CIC-IT - Inserm CIT808), CHU de Besançon, 25030 Besançon cedex, France
| | - L Pazart
- Centre d'investigation clinique en innovation technologique (CIC-IT - Inserm CIT808), CHU de Besançon, 25030 Besançon cedex, France
| | - E Weber
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France
| | - M Benassarou
- Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, CHU de Besançon, 3, boulevard Fleming, 25030 Besançon cedex, France; EA 4268, laboratoire intervention, innovation, ingénierie en santé (Li4S), université de Franche-Comté, 25030 Besançon cedex, France
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